Mobile Office Products
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MOBILE OFFICE PRODUCTS - PRINTABLE ORDER FORM

Mobile Office Products
Printable Order Form


Please print this form, provide all information requested, and return by fax or regular mail.
Fax to: 423-775-0611. Mail to: Interactive Products Corporation, 148 Bluff Road, Dayton, TN 37321.


Please Note: We DO NOT accept personal checks. We DO accept money orders.

Customer Billing Information
Name:
_________________________________________________________
Company Name:
_________________________________________________________
Bill to Address:

*Address must be as
it appears on your
credit card statement
________________________________________________________
_________________________________________________________
_________________________________________________________
City:
_________________________________________________________
State:
________________________
Postal Code:
___________________
Country:
________________________
Phone:
________________________
E-mail:
___________________

Customer Shipping Information
___ Check here if the Ship To Address is the same as the Bill To Address
 
Name:
_________________________________________________________
Company Name:
_________________________________________________________
Ship to Address:
_________________________________________________________
  _________________________________________________________
  _________________________________________________________
City:
_________________________________________________________
State:
________________________
Postal Code:
___________________
Country:
________________________
 
 
Credit Card Information
We accept Visa, Master Card, Discover and American Express.
 
Card Number:
__________________________
Expiration Date:
_______________
 
Mobile Office Product Information
Quantity: Size:
Description:
Item Number:
_______ ____ _________________________________ _________________
_______ ____ _________________________________ _________________
_______ ____ _________________________________ _________________
_______ ____ _________________________________ _________________
_______ ____ _________________________________ _________________
_______ ____ _________________________________ _________________

Interactive Products Corporation
148 Bluff Road, Dayton, TN 37321
Toll Free: 888-552-7867 Fax: 423-775-0611
© 1997-2007 Interactive Products Corporation. All Rights Reserved.
All brand names and product names used on these web pages are
trademarks or trade names of their respective holders.
For further information contact
ipc@laptraveler.com.